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UHC What must be explained to consumers enrolling in an HMO MA plan

Which of the following consumers are eligible for Medicare if other eligibility requirements are met?

Consumers age 65 or older, consumers under age 65 with certain disabilities for more than 24 months, and consumers of all ages with ESRD or ALS

Which of the following defines a Medicare Advantage Plan?

MA plans must provide benefits equivalent to Original Medicare, and most also offer additional benefits
MA plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage

Janice wants to enroll in a Medicare Advantage plan. Which of the following is NOT an eligibility requirement?

Does not have any pre existing conditions, such as diabetes or ESRD

What must be explained to consumers enrolling in an HMO MA plan?

The exception to the provider network requirement is emergency visits, urgent care and renal dialysis services, which can be obtained from out of network providers

They must see contracted network providers in order to receive coverage under the plan

Most benefits are covered out of network but at a higher cost

Which of the following are MA plans that focus on using network providers to maximize the benefits and reduce out of network expenses?

HMO, POS, PPO

When is Mary’s Medicare Supplement Open Enrollment period if she turns 65 on September 23, 2021, and her Medicare Part B effective date is September 1, 2021?

Sept 2021 – Feb 2022

Jennifer is enrolling into a Medicare Advantage plan and wants to know what counts toward the out of pocket maximum. Which of the following is accurate?

…

Margaret currently has a MAPD plan. What would happen if you enrolled her into a stand alone PDP?

…

What is Medicare Part D?

A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premium by

Which of the following is a fact about Medicare Prescription Drug Plan?

To enroll, the consumer must reside in the plans service area

Next Read: Mrs. Kelly, age 65, is entitled to Part A but has not yet enrolled in Part B »

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